| NPI | 1972951283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITA RIGGINS Hair Replacement Specialist 352-575-7032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO120920) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |